Organization Active NPI

Jillian Irwin DPM, P.C.

  • Podiatrist
  • Oceanside, NY
National Provider Identifier
1831701721
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
JILLIAN IRWIN DPM, P.C.
Practice address
395 Anchor Ave
Oceanside, NY 11572-2905
Phone
(516) 287-6555
NPI assigned
Aug 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jillian Elizabeth Irwin, DPMNPI 1801329073
Title
Owner
Phone
(516) 287-6555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

395 Anchor Ave
Oceanside, NY 11572-2905

Mailing address

395 Anchor Ave
Oceanside, NY 11572-2905
Phone (516) 287-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201005001074 NY Part B Supplier - Clinic/Group Practice 2466871843 Receives reassigned benefits from 1 practitioner
Practice locations: Oceanside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1831701721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 ANCHOR AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115722905",
            "telephone_number": "516-287-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 ANCHOR AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115722905",
            "telephone_number": "516-287-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILLIAN IRWIN DPM, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-287-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.